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Ann Thorac Surg 1976;21:7-11
© 1976 The Society of Thoracic Surgeons

Articles

Quadruple Coronary Artery Bypass Grafting

Jefferson F. Ray, III, M.D.*, William O. Myers, M.D., Frederick J. Wenzel, Robert C. Intress, P.A., James N. Beathard, P.A., Daniel J. Kummer, P.A., William J. Zirnhelt, P.A., Richard D. Sautter, M.D.

Marshfield Clinic and the Marshfield Medical Foundation, Marshfield, WI

Accepted for publication May 29, 1975.

* Address reprint requests to Dr. Ray, Marshfield Clinic and Marshfield Medical Foundation, 1000 N Oak Ave, Marshfield, WI 54449

In our last 150 consecutive revascularization operations, 30 patients (20%) have had 4 or more bypass grafts. One patient died after quadruple grafting (mortality, 3%). Twenty-two (75%) of the survivors have been rehabilitated to active work status and 25 (86%) were considered by their cardiologists to have improved function postoperatively by New York Heart Association criteria. Preoperatively 15 patients (50% of the group) had either a markedly diminished ejection fraction (EF) or extreme elevation in left ventricular end-diastolic pressure (LVEDP) or both. Complete revascularization, with resection of ventricular aneurysms when present, can be carried out successfully in a high-risk group of patients. Elevated LVEDP or diminished EF per se is not a valid contraindication to myocardial revascularization.




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